Peptic Ulcer Disease (PUD)

by Reena Cherian, NP

Peptic ulcers are open sores which develop in the lining of the esophagus, stomach or the first part of the small intestine (duodenum). When it is in the stomach it is called gastric ulcer. If it is in the 1^st part of the small intestine it is called duodenal ulcer.

Causes: Normally stomach and intestinal lining is protected against irritating acid. If there is a break down in the lining, inflammation develops which leads to ulcerations. The most common causes of such damages are infection by bacteria called helicobacter pylori and use of non steroidal anti inflammatory drugs such as Ibuprofen, Naproxen, and Aspirin. . Other risk factors include smoking, chewing tobacco, excessive alcohol use being very ill such as being on a ventilator and radiation treatment.

A rare condition called Zollinger- Ellison Syndrome can cause stomach and duodenal ulcers

Symptoms: The most common symptom is abdominal pain. Other symptoms may include feeling full, hunger and empty feeling, nausea, vomiting, upper abdominal discomfort, dark tarry stool, Chest pain and weight loss

Diagnosis: Can be made by obtain a detailed history and one or more of the following tests. Checking for h Pylori via stool, breath or blood test, Upper endoscopy and X ray of the upper GI tract

Treatment: If H pylori is present treatment will be focused to eradicate the bacteria with antibiotic therapy along with acid suppression therapy. If ulcer is due to NSADIs use, avoid NSAIDs use. Life style modifications such as avoiding smoking and alcohol helps. Acid suppression therapy with H2 Blockers such as Famotidine or Ranitidine or Proton Pump Inhibitors such as Omeprazole or Lansoprazole is also recommended

Complications: If untreated, ulcer disease may lead to bleeding complications and perforation.